Retrospective Study of a Sustained-Release Intracanalicular Dexamethasone Insert for Treatment of Ocular Inflammation After Cataract and Corneal Surgery.
Dextenza
Fuchs dystrophy
cystoid macular edema
graft rejection
intraocular pressure
steroid drops
Journal
Clinical ophthalmology (Auckland, N.Z.)
ISSN: 1177-5467
Titre abrégé: Clin Ophthalmol
Pays: New Zealand
ID NLM: 101321512
Informations de publication
Date de publication:
2022
2022
Historique:
received:
19
08
2022
accepted:
06
12
2022
entrez:
19
12
2022
pubmed:
20
12
2022
medline:
20
12
2022
Statut:
epublish
Résumé
To evaluate the effectiveness and safety of a sustained-release intracanalicular dexamethasone insert (Dextenza, Ocular Therapeutix, Inc.) as an adjunctive therapy in patients undergoing cataract and corneal surgery. This retrospective case series contains 18 patients undergoing cataract surgery and 6 patients undergoing corneal surgery. All patients received the Dextenza intracanalicular insert. 6/18 of the patients in the cataract surgery arm were on the standard of care post-surgery topical steroid drop regimen, whereas 11/18 of the patients were on a reduced regimen. 1/18 of the patients was on a drop regimen that deviated from the aforementioned regimens. 2/6 of the patients in the corneal surgery arm were on the standard of care post-surgery topical steroid drop regimen, whereas 3/6 of the patients were on a reduced regimen. 1/6 of the patients were on a drop regimen that deviated from the aforementioned regimens. The primary outcome measures are intraocular pressure (IOP) levels and anterior chamber inflammation levels across the post-operative recovery period. 1/18 of the patients in the cataract surgery arm and 1/6 of the patients in the corneal surgery arm experienced a clinically significant IOP spike greater than 10 millimeters of mercury (mmHg) above baseline IOP. No patient in either of the study groups had significant inflammation after 1 week post-surgery. 1/18 of the patients in the cataract surgery arm and 1/6 of the patients in the corneal surgery arm experienced a canalicular obstruction. Dextenza with the lower drop protocol showed non-inferiority in terms of inflammation management and safety. As with any steroid delivery mechanism, monitoring IOP is paramount when using Dextenza. One of the patients with a canalicular obstruction had a history of punctal plug implantation, so care should be taken when choosing to implant Dextenza in such a patient.
Identifiants
pubmed: 36532822
doi: 10.2147/OPTH.S386702
pii: 386702
pmc: PMC9749497
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4065-4074Informations de copyright
© 2022 Fram et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
Am J Ophthalmol. 2005 Sep;140(3):509-16
pubmed: 16196117
World J Pharmacol. 2013;2(2):47-64
pubmed: 25590022
J Cataract Refract Surg. 2019 Feb;45(2):204-212
pubmed: 30367938
Clin Ophthalmol. 2016 Nov 23;10:2329-2336
pubmed: 27920493
Dev Ophthalmol. 2008;41:193-212
pubmed: 18453770
Dermatol Clin. 1992 Jul;10(3):505-12
pubmed: 1617809
Curr Opin Ophthalmol. 2000 Feb;11(1):3-6
pubmed: 10724825
J Cataract Refract Surg. 2015 Oct;41(10):2049-59
pubmed: 26703279
Am J Ophthalmol. 2009 Jul;148(1):128-35.e2
pubmed: 19403110
Eye (Lond). 2009 Mar;23(3):708-14
pubmed: 18820657
Can J Ophthalmol. 2008 Aug;43(4):454-61
pubmed: 18711461
Clin Ophthalmol. 2014 Jun 25;8:1209-12
pubmed: 25028534
J Cataract Refract Surg. 1996;22 Suppl 1:770-4
pubmed: 9279670
Fed Proc. 1965 Nov-Dec;24(6):1274-8
pubmed: 5853148
J Cataract Refract Surg. 2014 Nov;40(11):1857-61
pubmed: 25248295
J Cataract Refract Surg. 2009 Apr;35(4):677-81
pubmed: 19304088
J Ocul Pharmacol Ther. 2017 Mar;33(2):79-90
pubmed: 28072552
Clin Exp Ophthalmol. 2020 Apr;48(3):366-401
pubmed: 31860766
J Cataract Refract Surg. 2021 Jul 1;47(7):963-964
pubmed: 33929796